Perhaps You Can't Blame Menopause for Your Insomnia After All

As we get older, sleep problems often become more common. It has long been suggested that for women, symptoms of menopause are to blame for sleep difficulties — however, is there any real science to support this claim?

A study published in the journal Menopause set out to estimate just how prevalent sleep problems are at menopause, and to determine the predictors of sleep issues at menopause.

The study involved 255 women aged between 35 and 48 who were premenopausal at the start of the study. All participants reached natural menopause during the 16-year follow-up period between 1996-2012.

None of the participants had any serious health issues known to affect ovarian function. Participants were not permitted in the study if they had suffered a major psychiatric disorder in the previous year, were pregnant or breast-feeding, had uncontrolled hypertension, were taking hormonal or psychotropic medications, or abusing alcohol or drugs.

Participants were assessed roughly every nine months over the course of 16 years. Data was collected primarily through in-home visits. These were timed to the days two-through-six (or the early follicular phase) of the menstrual cycle, for two consecutive menstrual cycles, or approximately one month apart in non-cycling women. Monitoring lasted for 14 assessment periods. The final two 15th and 16th assessments were conducted by telephone interview.

Sleep quality was measured through a validated menopausal symptom questionnaire that asked the following question:

“Have you experienced trouble sleeping in the past month?”

Additional questions then determined the frequency and severity of poor sleep.

Interestingly, at late postmenopause (at least three years after the final menstrual period), poor sleep was found to decrease slightly.

The primary predictor of poor sleep at menopauseAfter analyzing all the data, researchers found that** premenopausal sleep quality was the strongest predictor of poor sleep in the years around the final menstrual period.**

In fact, women with moderate to severe poor sleep before menopause were three-and-a-half times more likely to suffer from moderate to severe poor sleep around the final menstrual period.

Women with mild poor sleep before menopause were one-and-a-half times more likely to suffer from moderate to severe poor sleep around the final menstrual period.

Can we blame hot flashes for poor sleep at menopause?

Those with moderate to severe hot flashes were nearly twice as likely to experience poor sleep at the final menstrual period — however, hot flashes were not experienced by all of those who experienced poor sleep.

Other risk factors for moderate/severe poor sleep at menopause included anxiety and perceived stress.

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.